Evidence map›Paper›PMID 32424649›Full record

SynthesisNeurosurgical review2021

Incidence and risk factors of proximal junctional kyphosis after internal fixation for adult spinal deformity: a systematic evaluation and meta-analysis.

Jian Zhao, Kai Chen, Xiao Zhai, Kai Chen, Ming Li, Yanghu Lu

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurosurgical review, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
4.9field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 38 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
  9. Article
  10. Article
  11. Review
  12. Article
  13. Article
  14. Article
  15. Novel assessment of physiotherapy outcomes in adults with structural spinal disorders.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023
    Article
  16. Observational
  17. Article
  18. Article
  19. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Jian Zhao *Department of Orthopedics, Shanghai Changhai Hospital, Navy Medical University, 168 Changhai Road, Shanghai, 200433, China.
Kai Chen *Department of Orthopedics, Shanghai Changhai Hospital, Navy Medical University, 168 Changhai Road, Shanghai, 200433, China.
Xiao Zhai *Department of Orthopedics, Shanghai Changhai Hospital, Navy Medical University, 168 Changhai Road, Shanghai, 200433, China.
Kai ChenDepartment of Orthopedics, Shanghai Changhai Hospital, Navy Medical University, 168 Changhai Road, Shanghai, 200433, China.
Ming LiDepartment of Orthopedics, Shanghai Changhai Hospital, Navy Medical University, 168 Changhai Road, Shanghai, 200433, China. limingchspine@126.com.ORCID http://orcid.org/0000-0003-2680-0092
Yanghu LuDepartment of Orthopedics, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, 200336, China. 171807636@qq.com.
Second Military Medical University · CNShanghai Jiao Tong University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To investigate the factors associated with proximal junctional kyphosis (PJK). A systematic search was performed. The weighted mean difference (WMD) was pooled for continuous variables, and the odds ratio (OR) was calculated for dichotomous variables. The PJK group had higher values for age (WMD = 2.53, 95%CI = 1.38 ~ 3.68, P < 0.001), female gender (OR = 1.56, 95%CI = 1.29 ~ 1.87, P < 0.001), and diagnosed osteoporosis (OR = 1.58, 95%CI = 1.11 ~ 2.26, P = 0.01). Preoperatively, significant differences were detected in sagittal vertical axis (SVA) (WMD = 19.29, 95%CI = 16.60 ~ 21.98, P < 0.001), pelvic incidence minus lumbar lordosis (PI-LL) (WMD = 2.71, 95%CI = 0.25 ~ 5.18, P = 0.03), pelvic tilt (PT) (WMD = 2.64, 95%CI = 1.38 ~ 3.90, P < 0.001), lumbar lordosis (LL) (WMD = - 1.76, 95%CI = - 2.73 ~ -0.79, P < 0.001), and sacral slope (SS) (WMD = - 2.80, 95%CI = - 5.57 ~ -0.04, P = 0.001). At follow-up, the following were higher in the PJK group: thoracic kyphosis (TK) (WMD = 5.51, 95%CI = 2.23 ~ 8.80, P < 0.001), proximal junctional angle (PJA) (WMD = 9.07, 95%CI = 4.21 ~ 13.92, P < 0.001), and PT (WMD = 1.51, 95%CI = 0.31 ~ 2.72, P = 0.01). However, there was no significant difference in SS (P = 0.49), and SVA (P = 0.11) between groups. Fusion to S1 or pelvis significantly increased the risk of PJK (OR = 2.08, P < 0.001). Ligament augmentation reduced the risk of PJK (OR = 0.34, 95%CI = 0.21 ~ 0.53, P < 0.001) better than the use of laminar hook (OR = 0.46, P < 0.001). Although no difference was detected for preoperative SRS-22 score (P = 0.056), a lower score (WMD = - 0.24, 95%CI = - 0.35 ~ -0.14, P < 0.001) was detected in PJK group at follow-up. The elderly female ASD patients were more susceptible to PJK, especially for those with osteoporosis, high preoperative SVA, low LL, large PT, and LIV extended to pelvis. The use of laminar hook and ligament reinforcement at the proximal end might prevent PJK.

Indexed as

AdultAgedAge FactorsFemaleHumansIncidenceInternal FixatorsKyphosisLordosisLumbar VertebraeMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesRisk FactorsSex FactorsAdult spinal deformityProximal junctional kyphosisRisk factors

Identifiers

PMID32424649
OpenAlexW3026961114

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.